About 90% of the patients now taking Wegovy are getting it through health plans that hold the copayments for the drug to $25 per month or less, Novo Nordisk says.

What it means: The performance of arrangements like the new Wegovy cash-pay deal may help workers using cash held in health savings accounts or flexible spending accounts to save on Wegovy purchases now.

In the long run, the cash-pay deal market for high-profile drugs may, like the pet insurance market and the vision care market, show employers and their benefits advisors how the major medical market and the prescription drug market could work if the core health benefits markets were free from the kinds of laws, regulations and contractual arrangements that tie the core health benefits market in knots.

The gameboard: Novo Nordisk faces more competition for Wegovy than manufacturers normally face for popular new brand-name drugs because the U.S. Food and Drug Administration found that there was a shortage of semaglutide, the active ingredient in Wegovy. That temporarily created room for compounding pharmacies like Him & Hers to create their own versions of semaglutide.

The FDA recently declared that the shortage has ended. The FDA move means that some compounding pharmacies will have to stop selling their versions of semaglutide April 22 and others will have to end sales of their versions May 22.

Related: Pharmacies lobby FDA for right to keep making weight-loss drugs

Yale researchers have reported that manufacturing semaglutide costs less than $5 per month per patient.

A government report showed in November that the list price of Wegovy had held steady at $1,349.08 per month between 2021 and 2024 and that, possibly because of the shortages and the intense popularity of the drug, the average net price after health plan discounts had increased to $649.42 per month, from $534 per month.

In January 2024, Eli Lilly launched a mail-order program for its new-generation weight-loss drug, Zepbound, that charges cash-pay patients prices ranging from $349 to $699 per month.

At press time, Him & Hers was advertising its compounded version for a price starting at $99 per month.

Novo Nordisk emphasizes its disdain for the compounders in its announcement about the new Wegovy deal.

The new NovoCare arrangement helps Wegovy users "avoid the significant risks that can be posed by the compounding marketplace," the company says.